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Narra J Aug 2023Prostate cancer treatment can significantly impact erectile function, and penile rehabilitation has been proposed to improve the impacts. However, the effectiveness of...
Prostate cancer treatment can significantly impact erectile function, and penile rehabilitation has been proposed to improve the impacts. However, the effectiveness of penile rehabilitations after treatment of prostate cancer is scarce. The aim of this systematic review was to evaluate the effectiveness of different interventions of penile rehabilitation program after prostate cancer treatment. We conducted a comprehensive search of electronic databases, PubMed and Google Scholar, to identify randomized controlled trials that evaluated interventions for penile rehabilitation after prostate cancer treatment. Studies that met our inclusion criteria were systematically reviewed, and data were synthesized and analyzed. We identified 11 randomized controlled trials that evaluated different interventions for penile rehabilitation after prostate cancer treatment. The interventions included the use of phosphodiesterase type 5 inhibitors, intracavernous injections, vacuum erection devices, and penile rehabilitation programs. The data suggest that these phosphodiesterase inhibitors, intracavernous injections, vacuum erection devices, and penile rehabilitation programs are promising in improving erectile function after prostate cancer treatment. However, the optimal timing and duration of these interventions remain unclear, and there is a need for further research to determine their long-term effectiveness and safety. Healthcare providers should consider individualized approaches to penile rehabilitation, taking into account patient characteristics and preferences.
PubMed: 38454969
DOI: 10.52225/narra.v3i2.174 -
Nutrients Jan 2024Pre-exercise intake of caffeine (from ~3 to 9 mg/kg) has been demonstrated as an effective supplementation strategy to increase fat oxidation during fasted exercise.... (Meta-Analysis)
Meta-Analysis Review
Pre-exercise intake of caffeine (from ~3 to 9 mg/kg) has been demonstrated as an effective supplementation strategy to increase fat oxidation during fasted exercise. However, a pre-exercise meal can alter the potential effect of caffeine on fat oxidation during exercise as caffeine modifies postprandial glycaemic and insulinemic responses. Hypothetically, the effect of caffeine on fat oxidation may be reduced or even withdrawn during fed-state exercise. The present systematic review aimed to meta-analyse investigations on the effect of acute caffeine intake on the rate of fat oxidation during submaximal aerobic exercise performed in the fed state (last meal < 5 h before exercise). A total of 18 crossover trials with randomised and placebo-controlled protocols and published between 1982 and 2021 were included, with a total of 228 participants (185 males and 43 females). Data were extracted to compare rates of fat oxidation during exercise with placebo and caffeine at the same exercise intensity, which reported 20 placebo-caffeine pairwise comparisons. A meta-analysis of the studies was performed, using the standardised mean difference (SMD) estimated from Hedges' , with 95% confidence intervals (CI). In comparison with the placebo, caffeine increased the rate of fat oxidation during fed-state exercise (number of comparisons (n) = 20; = 0.020, SMD = 0.65, 95% CI = 0.20 to 1.20). Only studies with a dose < 6 mg/kg of caffeine (n = 13) increased the rate of fat oxidation during fed-state exercise ( = 0.004, SMD = 0.86, 95% CI = 0.27 to 1.45), while no such effect was observed in studies with doses ≥6 mg/kg (n = 7; = 0.97, SMD = -0.03, 95% CI = -1.40 to 1.35). The effect of caffeine on fat oxidation during fed-state exercise was observed in active untrained individuals (n = 13; < 0.001, SMD = 0.84, 95% CI = 0.39 to 1.30) but not in aerobically trained participants (n = 7; = 0.27, SMD = 0.50, 95% CI = -0.39 to 1.39). Likewise, the effect of caffeine on fat oxidation was observed in caffeine-naïve participants (n = 9; < 0.001, SMD = 0.82, 95% CI = 0.45 to 1.19) but not in caffeine consumers (n = 3; = 0.54, SMD = 0.57, 95% CI = -1.23 to 2.37). In conclusion, acute caffeine intake in combination with a meal ingested within 5 h before the onset of exercise increased the rate of fat oxidation during submaximal aerobic exercise. The magnitude of the effect of caffeine on fat oxidation during fed-state exercise may be modulated by the dose of caffeine administered (higher with <6 mg/kg than with ≥6 mg/kg), participants' aerobic fitness level (higher in active than in aerobically trained individuals), and habituation to caffeine (higher in caffeine-naïve than in caffeine consumers).
Topics: Female; Male; Humans; Caffeine; Exercise; Fasting; Meals; Oxidation-Reduction
PubMed: 38257100
DOI: 10.3390/nu16020207 -
Alternative Therapies in Health and... Oct 2023This meta-analysis aims to evaluate the effects of levosimendan on B-type natriuretic peptide (BNP) levels in patients with decompensated heart failure and assess the... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This meta-analysis aims to evaluate the effects of levosimendan on B-type natriuretic peptide (BNP) levels in patients with decompensated heart failure and assess the efficacy and safety of levosimendan in treating left heart failure.
METHODS
Randomized controlled trials (RCTs) were identified through searches in the Chinese Biomedical Literature Database (CBM), Chinese Academic Journal Full Text Database (CNKI), Wanfang Database (CECDB), VIP Chinese Scientific, PubMed, Cochrane Library, and Web of Science. Quality assessment and data extraction were performed for the included studies, and meta-analysis was conducted using Review Manager 5.2 software.
RESULTS
The meta-analysis revealed a statistically significant difference in the regulatory effect of levosimendan on BNP levels in patients with stage III heart failure compared to the control group [OR = 2.12, 95% CI (1.22, 3.67), P = .008, I2 = 37%, Z = 2.67]. Additionally, leosimendan showed a significant effect on BNP levels in patients with stage IV heart failure [OR = 1.88, 95% CI (1.27, 2.79), P = .002, I2 = 0%, Z = 3.14], compensatory heart failure [OR=2.97, 95% CI (1.81, 4.86), P < .0001, I2 = 55%, Z = 4.32], and decompensated heart failure [OR = 1.98, 95% CI (1.59, 2.47), P < .00001, I2 = 76%, Z = 6.07].
CONCLUSIONS
Levosimendan administration demonstrated improved cardiac function and a significant reduction in plasma BNP levels in patients with decompensated heart failure.
Topics: Humans; Simendan; Natriuretic Peptide, Brain; Heart Failure; Patients
PubMed: 37471659
DOI: No ID Found -
BMC Pediatrics Feb 2024Preterm labor (PTL) is a common and serious pregnancy disorder that can cause long-term neurological issues in the infant. There are conflicting studies concerning... (Meta-Analysis)
Meta-Analysis
Efficient administration of a combination of nifedipine and sildenafil citrate versus only nifedipine on clinical outcomes in women with threatened preterm labor: a systematic review and meta-analysis.
BACKGROUND
Preterm labor (PTL) is a common and serious pregnancy disorder that can cause long-term neurological issues in the infant. There are conflicting studies concerning whether sildenafil citrate (SC) reduces preterm labor complications. Therefore, the meta-analysis aimed to examine the clinical outcomes in women with threatened PTL who received nifedipine plus SC therapy versus only nifedipine.
METHODS
For the original articles, six databases were searched using relevant keywords without restriction on time or language until January 13, 2024. The Cochrane risk-of-bias tool for randomized trials (RoB) and the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS) were both used to assess the risk of bias in randomized and non-randomized studies, and GRADE determined the quality of our evidence. Meta-analysis of all data was carried out using Review Manager (RevMan) version 5.1.
RESULTS
Seven studies with mixed quality were included in the meta-analysis. The study found that combining nifedipine and SC resulted in more prolongation of pregnancy (MD = 6.99, 95% CI: 5.32, 8.65, p < 0.00001), a lower rate of delivery in the 1st to 3rd days after hospitalization (RR = 0.62, 95% CI: 0.50, 0.76, p < 0.00001), a higher birth weight (252.48 g vs. nifedipine alone, p = 0.02), and the risk ratio of admission to the neonatal intensive care unit (NICU) was significantly lower (RR = 0.62, 95% CI: 0.50, 0.76, p < 0.00001) compared to nifidepine alone. The evidence was high for prolongation of pregnancy, delivery rate 24-72 h after admission, and NICU admission, but low for newborn birth weight.
CONCLUSIONS
Given the effectiveness of SC plus nifedipine in increased prolongation of pregnancy and birth weight, lower delivery in the 1st to 3rd days after hospitalization, and NICU admission, Gynecologists and obstetricians are suggested to consider this strategy for PTL management, although additional article rigor is required to improve the quality of the evidence.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Nifedipine; Premature Birth; Sildenafil Citrate; Tocolytic Agents; Birth Weight; Obstetric Labor, Premature
PubMed: 38341578
DOI: 10.1186/s12887-024-04588-3 -
Journal of the International Society of... Dec 2024Caffeine, widely recognized as an ergogenic aid, has undergone extensive research, demonstrating its effectiveness to enhance endurance performance. However, there... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Caffeine, widely recognized as an ergogenic aid, has undergone extensive research, demonstrating its effectiveness to enhance endurance performance. However, there remains a significant gap in systematically evaluating its effects on time trial (TT) performance in cyclists.
PURPOSE
This meta-analysis aimed to determine the efficacy of caffeine ingestion to increase cycling TT performance in cyclists and to evaluate the optimal dosage range for maximum effect.
METHODS
A search of four databases was completed on 1 December 2023. The selected studies comprised crossover, placebo-controlled investigations into the effects of caffeine ingestion on cycling TT performance. Completion time (Time) and mean power output (MPO) were used as performance measures for TT. Meta-analyses were performed using a random-effects model to assess the standardized mean differences (SMD) in individual studies.
RESULTS
Fifteen studies met the inclusion criteria for the meta-analyses. Subgroup analysis showed that moderate doses of caffeine intake (4-6 mg/kg) significantly improved cycling performance (SMD = -0.55, 95% confidence interval (CI) = -0.84 ~ -0.26, < 0.01, = 35%; SMD = 0.44, 95% CI = 0.09 ~ 0.79, < 0.05, = 39%), while the effects of low doses (1-3 mg/kg) of caffeine were not significant (SMD = -0.34, 95% CI = -0.84 ~ 0.17, = 0.19, = 0%; SMD = 0.31, 95% CI = -0.02 ~ 0.65, = 0.07, = 0%).
CONCLUSION
A moderate dosage (4-6 mg/kg) of caffeine, identified as the optimal dose range, can significantly improve the time trial performance of cyclists, while a low dose (1-3 mg/kg) does not yield improvement. In addition, the improvements in completion time and mean power output resulting from a moderate dose of caffeine are essentially the same in cycling time trails.
Topics: Caffeine; Bicycling; Humans; Athletic Performance; Performance-Enhancing Substances; Dose-Response Relationship, Drug; Physical Endurance
PubMed: 38836626
DOI: 10.1080/15502783.2024.2363789 -
Journal of Cardiovascular Pharmacology Feb 2024In the latest years, several studies described the impact of repetitive/intermittent i.v. levosimendan treatment in the management of advanced heart failure. For this... (Meta-Analysis)
Meta-Analysis
In the latest years, several studies described the impact of repetitive/intermittent i.v. levosimendan treatment in the management of advanced heart failure. For this updated review, we systematically searched the literature for clinical trials, registries , and real-world data and identified 31 studies that we commented in a narrative review: 3814 patients were described, of whom 1744 were treated repetitively with levosimendan. On the basis of the nature of the study protocols and of the end points, out of those studies, we further selected 9 that had characteristics, making them suitable for a meta-analysis on mortality. This short list describes data from 680 patients (of whom 399 received repeated doses of levosimendan) and 110 death events (of which 50 occurred in the levosimendan cohort). In the meta-analysis, repetitive/intermittent therapy with i.v. levosimendan was associated with a significant reduction in mortality at the longest time point available: 50 of 399 (12.5%) versus 60 of 281 (21.4%) in the control arms, with a risk ratio of 0.62 (95% confidence interval, 0.42-0.90; P < 0.01). In a sensitivity analysis, removing each trial and reanalyzing the remaining data set did not change the trend, magnitude, or significance of the results. A visual inspection of the funnel plot did not suggest publication bias. The results provide a very strong rationale for continuing to investigate the repetitive use of levosimendan in patients with advanced heart failure by properly powered regulatory clinical trials. Meanwhile, it seems that the use of repetitive/intermittent i.v. levosimendan infusions has become one of the few effective options for preserving the hemodynamic and symptomatic balance in such patients.
Topics: Humans; Simendan; Cardiotonic Agents; Hydrazones; Pyridazines; Heart Failure
PubMed: 37991393
DOI: 10.1097/FJC.0000000000001506 -
Nutricion Hospitalaria Jun 2024Caffeine is a widely used ergogenic aid in society, which has made it a topic of interest due to its various benefits at cognitive, physiological, and sports levels,...
Caffeine is a widely used ergogenic aid in society, which has made it a topic of interest due to its various benefits at cognitive, physiological, and sports levels, among others. This review aims to investigate the potential benefits of caffeine supplementation in psychophysiological performance through a structured search in the SportsDiscus/Scopus/MEDLINE and Web of Science databases (October 2022). This review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guideline, and the inclusion criteria were defined based on the PICOS model. Double-blind, randomized/semi-randomized crossover articles comparing caffeine intake with an identical placebo condition were included. Filters by age or gender of the participants were not applied. The initial search gave a result of 201 articles, which after eliminating duplicates and applying the inclusion and exclusion criteria, the final sample for this review was 8 studies. The review concluded that 3 (37.5 %) found favorable ergogenic effects, 4 (50 %) found partial effects, and 1 (12.5 %) found no effects of caffeine supplementation on variables related to psychophysiological performance. In general, both partial and negative results could be linked to insufficient doses to produce any change, likewise, habitual caffeine consumption is also a variable that could be attenuating its potential ergogenic effect. In conclusion, moderate doses of caffeine 3-6 mg/kg seem to be an effective strategy to improve the psychophysiological response in various contexts without generating detrimental effects on performance, as long as the intervention designs consider the variables that could condition its effect.
Topics: Caffeine; Humans; Athletic Performance; Performance-Enhancing Substances; Dietary Supplements; Psychophysiology; Central Nervous System Stimulants; Randomized Controlled Trials as Topic
PubMed: 38666339
DOI: 10.20960/nh.04820 -
International Journal of Chronic... 2024The clinical efficacy of roflumilast, an oral phosphodiesterase-4 inhibitor, has been demonstrated in patients with severe chronic obstructive pulmonary disease (COPD).... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The clinical efficacy of roflumilast, an oral phosphodiesterase-4 inhibitor, has been demonstrated in patients with severe chronic obstructive pulmonary disease (COPD). However, roflumilast has shown frequent adverse drug reactions (ADRs). This study was performed to investigate the dosing strategy that will improve adherence to roflumilast in COPD.
METHODS
We conducted a systematic review and meta-analysis using PubMed, Embase, and Cochrane Central Register. The dosing strategy for roflumilast was classified into a dose-escalation group and a low-dose group. We investigated clinical outcomes according to dosing strategy.
RESULTS
Five clinical trials involving 2424 patients were included. Both the dose-escalation and the low-dose groups showed a decrease in discontinuation rate compared to the standard dosing group for roflumilast (risk ratio [RR], 0.81; 95% confidence interval [CI], 0.67-0.97; = 0.02 and RR, 0.62; 95% CI, 0.48-0.80; < 0.01, respectively). In the two strategies, the pooled proportions of discontinuation were 27.9% and 11.7%, respectively. Although the pooled proportion of any ADR was not statistically decreased in the two strategies, diarrhea was significantly reduced in the low-dose group compared to the standard group (RR, 0.58; 95% CI, 0.42-0.82; < 0.01). The pooled incidence of acute exacerbations was similar between the low-dose and the standard groups (22.9% and 20.1%, respectively; = 0.27).
CONCLUSION
Our findings show that the two alternative dosing strategies might have the benefit of improving adherence to roflumilast in COPD. Further large-scale trials are required to support our findings.
Topics: Humans; Pulmonary Disease, Chronic Obstructive; Aminopyridines; Benzamides; Cyclopropanes; Phosphodiesterase 4 Inhibitors
PubMed: 38476122
DOI: 10.2147/COPD.S440252